| NPI | 1558913202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT11809L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DAPT000128) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |